COMPARISON OF SAFETY AND EFFICACY OF ANTI HYPERTENSIVE DRUG COMBINATIONS (DIURETICS, CCBS, ARBS, BETA BLOCKERS,) IN PATIENTS WITH HYPERTENSION: A PROSPECTIVE OBSERVATIONAL STUDY

K. Pavithra*, R. Jenelia Williams, Dr. C. Venkatesh, Dr. N. M. Vageesh, Dr. B. Srinivasulu

ABSTRACT

Aim: Persistent hypertension increases the likelihood of cardiovascular events and kidney complications. If one medicine does not provide sufficient control, clinicians may prescribe a combination of antihypertensive agents. Decisions about therapy should account for blood-pressure response as well as tolerability. Objective: This study examined changes in blood pressure and serum creatinine during follow-up, the proportion of patients meeting the recorded blood-pressure target, and adverse effects documented for selected antihypertensive regimens. Methods and Methodology: A prospective observational study lasting six months was carried out at Aditya Nursing Home in Adoni, Andhra Pradesh. Records for 79 adults aged 35–95 years receiving inpatient or outpatient hypertension care were analysed. Information was abstracted from prescriptions, clinical documentation, laboratory results, and blood-pressure measurements. Assessments were documented at baseline and at follow-up, including visits at about one and three months. The project identified paired t-tests and one-way analysis of variance (ANOVA) as the planned analyses; individual patient data were not available to repeat these calculations independently. Results And Discussion: Both systolic and diastolic readings were lower at follow-up across all five regimens: telmisartan/hydrochlorothiazide, amlodipine/atenolol, telmisartan/amlodipine, telmisartan/chlorthalidone, and telmisartan/metoprolol succinate. The recorded systolic reduction was 40 mmHg for telmisartan/amlodipine (160 to 120 mmHg) and for telmisartan/chlorthalidone (180 to 140 mmHg). Average serum creatinine showed relatively small changes, with increases noted in the two groups receiving diuretics. According to the target-control table, 67 of 79 participants (84.8%) met the stated target. However, treatment-group totals are inconsistent across tables and must be checked against the original records. Conclusion: The project tables indicate lower follow-up blood pressure in each of the five treatment groups. A substantial systolic change was recorded for telmisartan/amlodipine, while mean creatinine rose slightly in some groups treated with diuretics. Given the observational design and unresolved discrepancies in the tables, these findings should be viewed as descriptive and cannot establish that one combination is better than another.

Keywords: hypertension; anti hypertensive agents; combination therapy; blood pressure; safety.